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Agri. 2020 Jan;32(1):8-18. doi: 10.14744/agri.2019.35403.

[Labor analgesia: Comparison of epidural patient-controlled analgesia and intravenous patient-controlled analgesia].

[Article in Turkish]

Author information

1
Health Sciences University, Antalya Training and Research Hospital, Anesthesiology and Reanimation Clinic, Antalya, Turkey.
2
VKV Medamerikan Medical Center, İstanbul, Turkey.
3
Ministry of Health Sultanbeyli State Hospital, Istanbul, Turkey.
4
Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Turkey.

Abstract

OBJECTIVES:

In our study, patient controlled epidural analgesia (PCEA) and patient controlled intravenous remifentanil analgesia (PCIVA) were compared for VAS, and also their side effects on mother and newborn.

METHODS:

In this study, 37 pregnant women with a single fetus, who had labor analgesia, were divided into groups of PCIVA (Group 2) and PCEA (Group 1). Bupivacaine 1.25 mg/ml and fentanyl 2 mcg/ml in 100 ml epidural solution were prepared for Group 1. The infusion dose was 15 ml, 5 ml divided doses. We set 5 ml/h basal infusion, 5 ml patient-controlled bolus and 20 min lock time. We prepared 2 mg remifentanil in 100 ml intravenous solution for Group 2. We set 20 mcg/h infusion, 0.05mcg/kg patient-controlled bolus and five min lock time. VAS, maternal-fetal heart rate, blood pressure, oxygen saturation, nausea-vomiting and sedation were recorded during labor. We recorded Apgar scores and maternal satisfaction at the end of labor.

RESULTS:

The findings showed that both groups could provide adequate analgesia. However, VAS scores were higher in Group PCIVA. The mother satisfaction and newborn's Apgar scores were similar. In both groups, desaturation, which is requiring oxygen support, was not determined. The oxygen saturations were lower in Group 2. The side effects and patient satisfaction were similar in both groups.

CONCLUSION:

Although PCIVA was found to be satisfactory concerning maternal satisfaction, VAS after 2nd hour were higher compared to PCEA. PCEA is the gold standard in labor analgesia. However, we believe that PCIVA is a good alternative to epidural analgesia in cases where epidural analgesia is contraindicated or where the patient does not want an epidural.

PMID:
32030699
DOI:
10.14744/agri.2019.35403
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